Lower eyelid tensometry in younger and older normal subjects

Abstract

Purpose This study aimed to establish normative and repeatability data for lower eyelid tensometry (LET) using a newly developed eyelid tensometer. Methods In this prospective consecutive observational case series, 32 normal adult subjects, comprising 12 younger (aged 2975 years, 6M : 6F) and 20 older subjects (aged 7476 years, 10M : 10F), underwent LET. In the younger group, LET was measured for posteroanterior (PA), nasal and temporal displacement. Duplicate measurements were taken and these were repeated on a separate occasion. Associations between repeated measurements and between right and left eyes were determined and the coefficient of repeatability for PA measurements was estimated. Differences in LET between males and females were determined using ANOVA. Only PA tensions, with duplicate measurements, were assessed in the older group, and age effects were determined. Results Mean temporal tension in the younger group was 7.872.9 mN (milliNewtons)/mm, while nasal tension was 13.074.6 mN/mm and PA tension was 11.275.3 mN/mm. There was a good correlation between interoccasion PA measurements (r ¼ 0.82-0.84, Po0.005) and between the right and left eyes (r ¼ 0.48, Po0.005). The coefficient of repeatability for PA tension was 1.8 mN/mm. In the younger group, overall eyelid tension (for all directions) for males was significantly higher than for females (ANOVA, P ¼ 0.03). For measurements in older subjects on a single occasion, PA tension was 11.173.5 mN/mm and in younger subjects 12.874.2 mN/mm (P ¼ 0.22). Conclusions LET is rapid, repeatable, feasible, and acceptable. PA tension was the most repeatable measurement. Younger males had higher eyelid tension than females, and there was no significant reduction in PA tension with age.

Influence of Eyelid Pressure on Fluorescein Staining of Ocular Surface in Dry Eyes

“…Eyelid tension or pressure has been measured by different instruments, [13][14][15][16] and although the instruments were different for each laboratory, there was general agreement that the eyelid tension or pressure decreased with increasing age in normal eyes as was found in our normal subjects. Interestingly, this significant decrease in the eyelid pressure was not found in the patients with dry eye.…”

“…12 Since then, eyelid tension or pressure has been measured by various instruments that measure the tension of the eyelid on the ocular surface. [13][14][15] However, a standardized method of measuring the eyelid tension or pressure has not been established because the methods and measuring devices were not easy to use and were not accurate.…”

Blepharo-Tensiometer

“…[15][16][17][18][19][20] King and Michels 19 as well as Martin 20 measured the muscular tension by electromyographic methods during blinking, although they focused on the changes of muscular tension at different blink rates under different psychological conditions. [15][16][17][18][19][20] King and Michels 19 as well as Martin 20 measured the muscular tension by electromyographic methods during blinking, although they focused on the changes of muscular tension at different blink rates under different psychological conditions.…”

The Relationship of Lid Wiper Epitheliopathy to Ocular Surface Signs and Symptoms

“…4,13 It explains why older individuals had a lower rate of LWE, as aging is linked to decreased lid pressure from the decline in muscle tone of the orbicularis oculi and involutional changes to collagen, elastin, and glycosaminoglycan in the eyelid. 37,49,50 It would explain why females were found to have a lower severity in LWE, as Francis et al 51 have found that females have lower lid tension than males. Finally, it could explain why Asians were nearly twice as likely to present with LWE than non-Asians and have a greater severity in LWE length and width, as the distinctive ocular anatomy in Asians, having greater herniation of orbital fat and smaller palpebral aperture size, may collectively contribute to greater lid pressure.…”